How Often Do You Need to Check Your Blood Sugar?

From everydayhealth.com/diabetes

Blood sugar checks are essential for the diagnosis and treatment of every form of diabetes. 

“Glucose monitoring is critical for preventing short-term and long-term complications of diabetes,” says Jessica Pius-Nwagwu, RN, an associate director of dissemination and implementation for the American Diabetes Association. “It provides real-time feedback on glucose fluctuations, identifies low and high glucose levels both with risks, and informs medical adjustments.”

There is no single recommendation for blood sugar monitoring that applies to everyone with diabetes. How often you should check your blood sugar varies according to your condition, the medications you use, and other health factors.

Types of Blood Sugar Measurements

There’s more than one way to measure your blood sugar.

Blood Sugar Meter or Continuous Glucose Monitor (CGM)

A blood sugar meter reveals your blood sugar level at the moment the test is taken.

Most people with diabetes are first taught how to measure their blood sugar with a blood sugar meter. You draw a drop of blood, insert it into a “fingerstick,” and receive the device’s reading of your blood sugar level at that moment. Depending on your diabetes management status, you may be advised to use a blood sugar meter multiple times a day, only once a day, or even less frequently.

For many people with type 2 diabetes, the most important time to use a blood sugar meter is first thing in the morning. This is known as a fasting blood sugar test, as it measures blood sugar after you have not eaten or drunk anything but water for at least the past eight hours. This can provide an important baseline of your blood sugar at its lowest level, unaffected by food, drink, exercise, and other daily habits.

Doctors may encourage others, especially those who use insulin to manage their type 1 or type 2 diabetes, to test their blood sugar multiple times throughout the day, including before and after meals and exercise. These checks can show how food and lifestyle choices affect diabetes management and can help determine how much insulin they need and how often.

A continuous glucose monitor (CGM) is a newer wearable device that sends blood sugar measurements to a smartphone or digital receiver around the clock, and it can sound alarms when blood sugar gets dangerously high or low. This can make it an important tool for people with type 1 or type 2 diabetes who want or need to track how and when their blood sugar rises and falls, though not all insurance plans cover CGMs.

Marilyn Tan, MD, a clinical associate professor of medicine specializing in endocrinology, gerontology, and metabolism at Stanford University in California, explains that CGMs measure changes in the interstitial fluid that contains blood sugar, rather than blood sugar itself.

“So readings may lag and may be less accurate at extremes of glucose [levels],” Dr. Tan says.

A1C Test

A haemoglobin A1C test measures your average blood sugar levels over three months. It does not give instant feedback on your diabetes management decisions. But your doctor may use it to diagnose prediabetes, type 1 diabetes, or type 2 diabetes or to determine how your diabetes treatment is progressing.

Your doctor may want you to have an A1C test as often as every three months, though people with more stable blood sugar control may need a check only once or twice a year.

Typically, a doctor administers an A1C via a blood draw or finger prick, with a sample sent to a lab to process results. Over-the-counter, at-home A1C tests are available. Ask your doctor if they are appropriate for your situation.

Type 2 Diabetes Without Insulin

If you are among the people with type 2 diabetes who do not need insulin to manage their condition, you might not need to check your blood sugar as often as people on insulin. But self-monitoring may be beneficial.

Pius-Nwagwu says that people with type 2 diabetes not on insulin should do a fasting blood sugar test daily, in addition to an A1C test that usually occurs quarterly. She adds that you should check with your doctor about the best frequency for your situation.

Tan says that frequency may depend on factors that include:

• How controlled your diabetes is
• Medications such as sulfonylureas that lower blood sugar
• Availability of test strips

She adds that checking blood sugar after meals may be helpful if you have type 2 diabetes without using insulin, but random blood sugar checks otherwise are usually unnecessary.

Although CGMs are not part of the usual standard of care for people who do not use insulin, research also suggests that they can help monitor blood sugar levels.

Type 2 Diabetes With Insulin

If your type 2 diabetes treatment requires insulin, your doctor may tell you to test your blood sugar several times a day. This is in part to avoid the threat of low blood sugar (hypoglycaemia), a potentially dangerous side effect of insulin use.

According to the American Diabetes Association, you may need to do as many as 6 to 10 daily checks, including:

• Before meals
• • Before bed
  • Occasionally after meals
  • Before, during, and after exercise
  • When you suspect low blood sugar
  • After treating low blood sugar
  • Before and during critical tasks, such as driving
  If you take a long-lasting basal insulin only once daily, you may require fewer checks than someone who also takes insulin at mealtimes.

  “Typically, someone on multiple daily injections of insulin (basal bolus) needs closer monitoring than someone on once-daily, long-acting insulin,” Tan says, “especially given that there are multiple opportunities to adjust dosing throughout the day and also more opportunities to overdose or underdose on insulin.”

  Tan says that people with insulin-dependent type 2 diabetes should do daily fasting blood sugar checks, with additional random blood sugar checks if unusual symptoms occur. Fasting blood sugar monitoring can help you adjust doses of basal insulin and ultimately lower your blood sugar levels.

  If you have type 2 diabetes and are on insulin, Pius-Nwagwu recommends testing A1C at least twice a year and quarterly if you are not meeting your A1C goals, regardless of the type of insulin. 

• CGMs also can help, Tan says. Evidence suggests that people with type 2 diabetes who are on insulin benefit from CGM use by increasing control over blood sugar and lowering hypoglycaemia risk.

  “Even once-daily, long-acting insulin can lead to hypoglycaemia, so all of these patients can benefit from a CGM,” she says.  

  Prediabetes or Family History of Diabetes

  If you have prediabetes or a family history of diabetes, you may be at risk for diabetes and benefit from blood sugar monitoring.

  Prediabetes means your blood sugar is elevated slightly, and your condition may progress to type 2 diabetes. If you have prediabetes, your doctor may want you to take an A1C test every one to two years, or more often, to monitor your potential progression toward full-blown diabetes.

  “For those with established prediabetes, an A1C test every three to six months is reasonable,” says Tan, who adds that the frequency depends on how close test results are to type 2 diabetes.

  If you have a family history of type 2 diabetes, the American Diabetes Association recommends A1C testing for screening and potential diagnosis. If your family history includes type 1 diabetes, it also recommends screening for type 1 diabetes autoantibodies.

  Although people without diabetes have used CGMs to monitor their blood sugar levels, there is little or no research showing that the devices benefit people with prediabetes. But some experts have argued that CGMs could help with diabetes prevention.
  Type 1 Diabetes

  Blood sugar checks are critical for people with type 1 diabetes, which requires insulin treatment. People with type 1 diabetes generally have to use insulin before every meal, frequently adjusting their doses based on their food, their physical activity level, and many other factors. It is extremely difficult to dose insulin accurately if you don’t know what your blood sugar level is.

  The American Diabetes Association also recommends 6 to 10 blood sugar tests daily for people with type 1 diabetes, including before and after meals, before bed, during exercise and critical tasks, and during times of high and low blood sugar levels.

  Given a nearly constant need for accurate blood sugar measurements and an enhanced risk of hypoglycaemia, the American Diabetes Association recommends that people with type 1 diabetes use CGMs.

  As for A1C tests, Osagie Ebekozien, MD, MPH, the chief quality officer at the American Diabetes Association, says people with type 1 diabetes should get them quarterly, though the association’s guidelines say controlled type 1 diabetes may require only two tests a year.
  

  Can You Test Your Blood Sugar Too Often?

  As a general rule, data on blood sugar is a good thing when it comes to diabetes management.

  “For healthcare providers, more data is helpful,” says Tan, adding that more tests can guide treatment decisions and monitor blood sugar fluctuations.

  Blood sugar monitoring, however, can contribute to diabetes burnout and feeling overwhelmed. Costs of testing devices can add up, and finger pricks can be painful.

  When in doubt, check with your doctor or endocrinologist about how much you need to monitor your blood sugar for your situation. Mental health support can also help you deal with difficult emotions related to diabetes care.

  The Takeaway

  • Routine blood sugar monitoring is a vital part of diabetes management and can prevent complications.
  • Testing options include fingerprick tests, continuous glucose monitoring (CGM), and A1C tests that measure longer-term averages.
  • If your type 1 or type 2 diabetes requires insulin treatment, you may require as many as 10 blood sugar tests each day, and could benefit from even more by using a CGM.
  • Always talk to your doctor about which blood sugar monitoring plans will work best for your specific condition.

  https://www.everydayhealth.com/diabetes/how-often-do-you-need-to-check-your-blood-sugar/